Perceptions of School Nurses in Addressing Student Mental Health Concerns: An Integrative Review

A Qualitative Study of School Nurses' Experience of Secondary Trauma

This qualitative descriptive study explored school nurses' experiences of exposure to reports of trauma from those in their care. Online interviews of school nurses practicing in NJ, USA, were recorded and transcribed verbatim. The study found that school nurses were exposed to reports of others' trauma to varying degrees, with those serving in urban settings reporting more stories of exposure than those in suburban settings. Reports included numerous, layered traumas at the community and individual levels, including students' poverty-related adversity and psychological distress. Qualitative content analysis revealed four categories: Health Office as Safe Haven, Challenges Working Within the School Model, Things That We Hear: Reports of Trauma, and The Ripple Effect of Trauma. School-based challenges included a lack of collaboration, misunderstanding of the school nurse's role, and workload issues such as competing demands and limited time and resources. School nurses reported focusing on the individual's immediate needs and processing the experience afterward. They acknowledged they can only do so much, and shared stories of coping and resilience. Additional education, resources, and support in addressing student trauma can enhance the provision of school nursing services and support the well-being of school nurses, students, and staff. Further research is warranted with a larger and more diverse sample of school nurses, including attention to school nurse wellness and resilience strategies.

A job analysis of mental health nursing in a school for students with intellectual and developmental disabilities

While schools have become settings for the delivery of mental health supports to students, mental health nursing has not yet described its practice in schools. In the absence of this mental health nursing literature, a quantitative self-reporting job analysis methodology was used to describe the tasks of mental health nursing in a specialist school as an observant-participator in a single-case holistic case study. Additional aims were to compare the results with the general school nursing and the disability nursing literatures and interpret these findings for mental health nursing. Categories of tasks from general school nursing were used to deductively interpret the results. Tasks were recorded across all categories of school nursing. The greatest number of tasks were recorded in the professional performance category, followed by planning, then personnel. The least number of tasks were recorded in the health education and promotion category, followed by practice and treatments, assessment and diagnosis, and management. These results differ from tasks in general school nursing but share similarities with intellectual and developmental disability nursing, particularly related to relationships and communication. Practising effectively as a mental health nurse in a specialist school requires capabilities for working with people with disability, particularly communicating and establishing relationships, in addition to clinical mental health skills. Mental health nursing in schools is an area of practice that requires further exploration to capitalise on emerging policy developments to support student mental health.

School Nurses' Perceived Role and Capacity to Support School Behavioral Health Programs in DC Public and Public Charter Schools

School nurses (SNs) practicing in DC public and public charter schools were surveyed to assess their perceived role and self-reported preparation to provide behavioral health prevention, early identification, and treatment services in schools. A total of 154 SNs completed a questionnaire about their role in the delivery of behavioral health services and supports. SNs reported they are primarily involved in the identification and referral of students to other school behavioral health professionals. Respondents also reported a lack of training in behavioral health and a desire for more information on related programs and services. This study offers recommendations for educating future SNs and highlights how the DC School Health Services Program utilized study findings to build capacity for SNs employed in practice. This study can help tailor educational opportunities for SNs to maximize their role in school behavioral healthcare process flows and ultimately improve outcomes for students and families.

School Health Services' Use of Information and Communication Technologies in Interorganizational Collaboration Regarding Students With Mental Illness: A Scoping Review

School health services (SHSs) and school nurses play a crucial role in identifying and supporting students with mental illness. The integration of information and communication technology (ICT) can facilitate interorganizational collaboration in this context. Due to the limited research in this area, a scoping review was conducted to explore SHSs' use of ICT in interorganization collaboration regarding students with mental illness. Six articles were reviewed, revealing three key themes: "types of ICT employed by SHSs in interorganizational collaboration," "constellation of SHSs in interorganizational collaboration," and "opportunities and challenges for SHSs using ICT in interorganizational collaboration." Notably, two of the six articles highlighted the absence of school nurses in interorganizational collaboration. Even though ICT plays a crucial role in interorganizational collaboration, no comprehensive solution was found. This scoping review confirms that there are challenges with operability and regulations that govern the exchange of private information between organizations.

Hidden and unacknowledged: The mental health and psychosocial interventions delivered by school nurses in Western Australia

Schools are an important setting for the early identification, assessment and intervention of mental health problems in children and young people. Internationally, many nurses work in schools, but the role of this group with young people experiencing mental health problems has had only limited investigation. This study explored the activities school nurses undertook with young people experiencing mental health problems in Australia. Reporting was guided by the COREQ checklist. Thirty-one nurses participated in a semi-structured interview. Data were analysed using the constant comparative method of analysis as developed by Glaser and Strauss (1967). The findings identified that nurses working in schools undertake a complex and sophisticated workload to support this cohort. In addition to assessment and referral for treatment, interventions assisted young people to manage challenging life circumstances, cope with intensely difficult emotions and improve their social and occupational functioning. The work of school nurses with young people experiencing mental health problems is hidden and unacknowledged. A better understanding of the mental health work school nurses undertake can inform enhanced service provision for children, young people and their families. The research findings will be of interest to mental health nurses, education professionals, parents, policy makers and governments.

Disparate discipline faced by black youth: The need for bias mitigation and school nursing impact to promote school connectedness

School connectedness is needed to improve youth mental health. Developing a school connection is more arduous for Black youth with a history of pervasive exclusionary discipline. This narrative review discusses academic and socioemotional consequences of school removals while highlighting disparities for Black youth. A comprehensive literature search was conducted, identifying relevant studies and publications using electronic databases; results from the last ten years were preferable but older references were included if deemed important. Recommendations for elevating the influence of school nursing has been included to help mitigate disparities and racial bias, considering historical discipline trends and rising mental health needs.

Promoting young people's mental health: the role of community nurses

There are growing concerns about the mental health and well-being of young people, including how these have been negatively affected by factors such as the coronavirus disease 2019 (COVID-19) pandemic and social media. Community nurses are in an ideal position to promote positive mental health and ensure timely referral to appropriate services to enable young people to access the support they need. This article explores how the pandemic and social media have affected young people's mental health, particularly in relation to anxiety. It also explains how nurses can discuss these issues with young people and their parents or guardians.

Religiosity, stress, and depressive symptoms among nursing and medical students during the middle stage of the COVID-19 pandemic: A cross-sectional study in Morocco

BACKGROUND

Recent studies on nursing and medical students showed a higher prevalence of depression and stress than the general population. Religiosity and spirituality are common in Muslim countries and are usually used as a means of coping strategy for psychological and mental disorders.

OBJECTIVE

Our objective was to evaluate the association between religious actions, depressive symptoms, and stress among students of nursing education lasting 3 years and students from the first 3 years of medical education lasting 7 years. The study was conducted at Ibn Zohr University of Agadir, Morocco.

METHOD

A sample of different stages of nursing and medical students was recruited. Religiosity was assessed by Muslim Belief into Action (M.BIAC) scale. The depressive symptoms and stress were, respectively, assessed by the Beck Depression Inventory (BDI-II) and Perceived Stress Scale (PSS).

RESULTS

Four hundred and thirteen students participated in this study. Our results showed a high prevalence of depressive symptoms (62.2%) and stress (66.8%). The depression scores were higher in the following subsample categories: students in the first 2 years of studies, female medical students, and nursing students with significant differences. The recorded religiosity was greater among students without depression compared to students with depression (p < 0.001). In the multivariate regression, the BIAC score demonstrated religiosity as neither a risk factor nor a protective factor of depression.

CONCLUSION

Religiosity constitutes a protective factor of depression and stress among nursing and medical students. This should improve the student's ability to cope with stressful situations during their training. Prospective studies are needed to further investigate this association and how religiosity improves mental health. This would contribute to improved academic performance and wellbeing among medical and nursing students.

Examination of Current Anxiety Problems with School Engagement and Volunteer and Paid Work among U.S. Adolescents

This study examined the relationships between current anxiety problems and school engagement, community service or volunteer work, and paid work among U.S. adolescents. The 2018-2019 National Survey of Children's Health (NSCH) dataset was analyzed and included 24,609 adolescents ages 12-17 years. We conducted unadjusted and adjusted logistic regression analyzes. A total of 12.6% of adolescents had healthcare provider-confirmed current anxiety problems. Adolescents with current anxiety were at decreased odds of engaging in school (aOR = 0.35, 95%CI = 0.29, 0.41) and participating in community service or volunteer work (aOR = 0.72, 95%CI = 0.59, 0.86) compared to adolescents without current anxiety. Adolescents with current anxiety were at increased odds of participating in paid work (OR = 1.18, 95%CI = 1.01, 1.38). This study reports that U.S. adolescents with anxiety were less likely to engage in school and participate in community service or volunteer work, but were more likely to participate in paid work compared to their peers without anxiety. Results should inform future interventions targeting adolescents.

Student safety in middle school: Implications for school nurse and teacher collaboration

OBJECTIVE

Adolescent suicide is a public health crisis. School connectedness, a protective factor, may be especially important in low-income rural schools, with fewer resources and higher rates of suicide as compared to urban schools. The purpose of this study was to explore teacher perceptions of safety and school connectedness in a low-income, rural middle school, and implications for collaborative practice between school nurses and teachers.

DESIGN AND SAMPLE

A qualitative secondary data analysis was used. Data were taken from transcripts from four focus groups comprised of middle school teachers (n = 20).

MEASUREMENT

An inductive approach to content analysis was conducted using in vivo Coding and Venn diagrams.

RESULTS

Three themes were identified: (1) defiant and aggressive student behaviors were safety concerns, as teachers perceived they may be obscuring mental health needs; (2) teachers were sometimes placed in a position to assist students with safety management strategies; and (3) managing safety concerns was an obstacle to building connectedness, as reflected in safety and school connectedness.

CONCLUSION

Collaborative strategies between school nurses and teachers are essential to identify student behaviors that may be masking mental health needs. Strategies have the potential to enhance school connectedness and support student safety.